Colorectal cancer is the fourth most common cancer in the US, with 4.1% to 4.4% of the population being diagnosed with it at some point during their lifetimes. It is also one of the most common causes of female mortality.
In fact, the incidence and mortality of colon and rectal cancer are higher in women than in men over 65, indicating it is a major threat to older women. But why is that so? What is the reason behind this higher cancer prevalence?
Let’s find out.
What is colorectal cancer?
Colorectal cancer is a disease in which your gut cells (mainly the ones that create mucus and other fluids) begin to grow uncontrollably, causing the development of polyps or growths in the inner lining of your colon.
Over time, these growths may become cancerous (meaning they can develop the ability to spread to other parts of the body). This usually takes ten years. If left untreated, these growths can work their way through to the liver and lungs via the lymphatic system.
Can women get colorectal cancer?
Yes, women can get colorectal cancer. But they exhibit delayed colorectal cancer development, usually showing signs at ages 55, 60, and 65 compared to men who tend to develop the disease a bit earlier at 50, 55, and 60.
However, they’re at a higher risk of getting right-sided colorectal cancers, which are more aggressive compared to their left-sided counterparts and more advanced at diagnosis. This type of colonic tumor is also flatter, making it harder to detect it during a colonoscopy.
Moreover, studies have shown that the risk of getting right-sided colon cancer increases if a patient is female, older, and Black.
Symptoms of colorectal cancer
Colorectal cancer doesn’t develop waving a flag. Instead, its growth is slow and insidious, and you might not even know you have it until you begin experiencing severe symptoms. This makes learning about the signs of colorectal cancer crucial, especially if you’re an older woman. Colon cancer symptoms include:
- Anemia (shortness of breath)
- Cramping, pain, or vomiting (without any reason)
- Persistent and severe belly pain
- Bloating that lasts for more than a week
- Persistently abnormal bowel habits
- Not feeling “empty” after a bowel movement
- Unexplained weight loss without a calorie deficit
- Rectal bleeding, which refers to dark or bright red blood in your stool (this can also be a sign of anal fissures or hemorrhoids).
- Dark or black stools
- Decreased appetite
What are the risk factors of colorectal cancer?
Old age, certain dietary patterns, smoking, obesity, racial factors, and physical inactivity are all risk factors for developing colorectal cancer. Here is a more detailed insight into each of these:
Age
The incidence risk of colorectal (CRC) increases as you age, doubling every five years and increasing 30% thereafter. In fact, the average age of CRC diagnosis is 69 years in women and 66 years in men.
However, the median age of CRC diagnosis has fallen in recent years as colorectal cancer incidence is rising in young adults.
Genetic mutations
There are a number of genetic mutations that increase the risk of colorectal cancer symptoms. For example, BRCA is a tumor suppressor gene that normally prevents cancer in women. But if it gets damaged, it can increase the risk of colon and ovarian cancer in women.
Similarly, some women have a mutation of the STK11 gene on chromosome 19p13.3. This leads to a condition called the Peutz-Jeghers syndrome, where women are at a higher risk of developing colorectal, ovarian, breast, and pancreatic cancers.
Finally, women with Lynch syndrome — where there is a defect in DNA repair genes — are also at an increased risk of colorectal cancer, ovarian cancer, endometrial cancer.
So, if you have a family history of colon cancer, you should educate yourself about colon cancer symptoms and be on the lookout for them. It’s also a good idea to be aware of genetic testing for colon cancer.
Race/Ethnicity
CRC incidence and mortality are the highest in African Americans, Pacific Islanders, Asians, and American and Alaska Natives (AIANs). For instance, African Americans have a 20% higher likelihood of getting CRC compared to non-Hispanic whites and 50% higher than Asians and Pacific Islanders.
Moreover, CRC incidence rates in African Americans are almost 40% higher than those in Caucasian people and double those in Pacific Islanders and Asians. These high rates are most likely related to lower socioeconomic status.
For instance, the average white household had $188,200 in wealth compared to $24,100 held by Black households, with 8.6% and 17.1% living in poverty respectively. This means Black people have a lower likelihood of getting colorectal cancer screening tests, an unfortunate situation for older Black women.
High red meat consumption
According to a review done at The George Institute for International Health, University of Sydney, high consumption of processed red meat increased CRC risk by 20%. In another study, a daily increase of 25g of processed and 100g of red meat led to a 49% and 17% increase in CRC.
Moreover, people who ate more red meat had a higher chance of getting rectal instead of colon cancer. When adjusted for risk factors like smoking and physical activity, high red meat consumption increased CRC risk by 29% for both males and females. So, you might want to reduce your red meat consumption, especially if you’re an older woman.
Dietary factors
At least 50% of colorectal cancer cases are attributed to dietary factors. For instance, a high carbohydrate intake has been shown to increase the risk of right-sided colon cancer in women and rectal cancer in men.
Similarly, a diet high in fat can also increase the risk of both left- and right-sided colon cancer for both men and women. Trans fat, polyunsaturated fat, and cholesterol are particularly associated with a higher risk of right-sided colon cancer in women.
Smoking
While smoking isn’t a risk factor for colorectal cancer (CRC) according to the US Surgeon General, a meta-analysis by Harvard School of Public Health suggests that current smokers have a 40% higher risk of CRC mortality and a 17% higher risk of developing this type of cancer compared to “never smokers.”
In contrast, former smokers have a 25% relative risk of developing CRC and a mortality risk of 15%.
Moreover, an increase of one pack/day (20 cigarettes) can increase CRC risk by 17.5% and CRC mortality by 40.7%. Similarly, two packs/day can cause a 38% increase in relative risk for CRC incidence and a 98% increase in CRC mortality.
Physical inactivity
People who don’t exercise at least 30 minutes a day have a high risk of having colon cancer. That’s because the colon is susceptible to insulin factors that encourage tumor growth. For instance, in a 16-year study, women who walked for 1 to 1.9 hours/week had a 31% lower risk of colon cancer than those who didn’t.
Moreover, women who spent at least four hours/week on moderate to vigorous activities had a 44% lower risk of CRC than those who worked out less than one hour/week. They also eliminated the risk of having colon cancer if they participated in long-term physical activity.
Obesity
Even if they’re physically active, people with a BMI higher than 30 kg/m2 have a 40% higher risk of CRC compared to those with a BMI of less than 25 kg/m2.
In fact, obese men have a 25% higher risk of getting rectal cancer and a 50% chance of developing colon cancer. Similarly, obese women have a 10% higher chance of getting colon cancer (but not rectal cancer).
Moreover, a higher risk is associated with a high waist-to-hip ratio and more abdominal fat. This can lead to an early onset of CRC among women and reduce the survival rates of CRC for both men and women.
Can women get colon cancer? Yes, they can!
Colorectal cancer occurs in both men and women, with men developing the disease earlier than women. However, women are more likely to develop more aggressive forms of CRC, especially right-sided, flat tumors that are difficult to detect.
Fortunately, colorectal cancer is treatable. And the earlier you get diagnosed, the higher your chances of treatment success.
So, if you’ve been experiencing any of the symptoms of colon cancer mentioned above, it’s crucial to get yourself checked. This is especially important if you’re an older Black woman. Safe is better than sorry.
